Hospital or Home: How Did You Decide Where to Birth Your Baby?

As I creep towards the halfway mark of my second pregnancy, I’m confronted by questions around which I’ve been tip-toeing: Where, oh where, will my baby be born? Should I go the hospital route again? Should I get my homebirth on this time?

Between my heavy crush on the idea of birthing my baby in the intimacy of my own home and the biting admonitions of a certain blogging skeptical obstetrician, I’m kind of, well, lost. I know what I want, and I know what I absolutely do not want, and I’m feeling a bit uptight and weary about the ability to marry the two.

You see, I got a whole lotta love for my first birthing experience. It was  empowering, awe-stoking, and filled with support and respect. My birth plan was honored nearly to the letter (there was a small hiccup with my request for delayed cord clamping), and even if I could I wouldn’t change a single thing about how my unmedicated, doula-assisted, Hypnobabies-bolstered hospital birth unfolded. (Okay, maybe I could have done without the stubbornly posterior bebe and the third degree tear.)

2012 National Rally for Change in St. Louis, MO, advocating for informed consent and evidence-based maternity care.*

But what I recognize about my hospital birth is this: the circumstances of my hospital birth experience aren’t du jour. In fact, I don’t think it’d be improper to describe those circumstances as exceptional. I worked in the women’s and children’s care center in the hospital where I delivered my son. Day in and day out for years preceeding my pregnancy and my son’s birth, I worked elbow-to-elbow with those professionals–the L&D/postpartum care/NICU nurses, lactation consultants, obstetricians, neonatologists, and pediatricians– in the position to care for me and my baby.

When the time came for me to choose an OB, I already had a pretty sound understanding, based on my professional experience, of which ones I didn’t want anywhere near my vag. When I had questions about how experienced my nurse co-workers were in supporting a patient aiming for an unmedicated birth, or how receptive they would be to the presence of my doula, or if I would be able to take my placenta home with me, I simply walked a few short strides from my office to that of the L&D nurse manager, plopped my pregnant rump down across from her, and asked my questions. When I had questions about breastfeeding resources and support, all I had to do was wave over one of my fantastic lactation consultant colleagues, and they eagerly shared their insight. I had a ton of support and intel at my fingertips long before I was wheeled up to L&D rockin’ 9cm of righteous dilation in my amniotic fluid-soaked yoga pants.

I will openly admit that I enjoyed an uncommon measure of comfort, privilege and preferential treatment birthing my baby and recovering amongst my hospital friends and co-workers. I do not hesitate to credit my unique circumstances for much of the ease I experienced navigating hospital birthing care. The biggest takeaway from my birth experience was this: the relationship you have with your care providers is integral, immeasurable, and irreplaceable.

Happy birthday, my sweet boy

I left that employment for stay-home mamahood, and our family has since relocated out of state to St. Louis. While I understand that each pregnancy and birthing experience is unique, I am acutely aware that the level of care and support I received in the past simply cannot be replicated here. And I have deeply felt reservations about a hospital birth this go ’round.

I’m currently under the care of an OB who as a reputation for supporting patients who desire a less interventive birthing, but I’m full of uncertainty about the hospital where she delivers. Sure, I could switch care providers; I could select an OB who delivers at a hospital with a better rep. Even still, I am nail-biting my way around the implicit fact that a hospital birth here would involve a few things on which I do not wish to compromise. (For example, I want my son to be integrated, when appropriate, into the birth experience of his sibling. And I do not want to be seperated from him for any great length of time, and especially not overnight. We’ve never spent a night apart.)

All signs seem to point to homebirth. Except, you know, those angrily flashing ones on the blog of a certain skeptical obstetrician. I fell down that rabbit hole, reading post after post about the inherent irresponsibility and acute risk of birthing your baby anywhere but a hospital. My cage? Rattled.

I interviewed a highly and repeatedly recommended certified professional midwife here in my neighhborhood, and I left feeling a bit lighter about the prospect of a homebirth. I am considering transferring to her care. In the coming days I will be following up with my insurance company to ascertain the extent of my benefits for an out-of-hospital birth. If nothing was covered at all and I needed to pay the full cost out of pocket, the math shows that I’d be spending just a couple of hundred dollars more than what I paid for my OB and hospital birth with my son. Cost, as I understand it at this point, is not a deterrent.

There is a birthing center scheduled to open this fall about an hour’s drive from where I live in the city. I’ve spoken with the certified nurse midwife heading up that effort, and she, too, was lovely and resourceful. Still, I’m uncertain about the idea of driving an hour away to have my baby. But maybe it’d be worth it?

Help a hormotional pregnant lady out: Did you struggle with the question of where to birth your baby/ies? What helped you confidently forge a decision? What resources/reading did you find particularly helpful?

*Wanna know more about informed consent and evidence-based maternity care? Check it out here.

Rhianna blogs from her adopted hometown of St. Louis, and never before has she missed her former hometown (and its awesome nurses) as much as she does right now. Things keeping her awake at night: crane-kicks to the kidneys courtesy of her bedsharing toddler; in utero dance party courtesy of wiggly fetus; and the anxiety surrounding the place in which the two will meet for the first time.

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